Increasing degrees of force applied to joints result in joint injury. Such joint injury is frequently seen as a result of trauma, for example chondral lesions are often seen in athletes, and are typically associated with acute inflammation. The treatment of joint injuries (such as ligamentous rupture or meniscal tearing) and rehabilitation of the patient after such injuries involves a number of components. Immediate care after the injury typically includes rest, cold application, compression and elevation. The aim of this treatment is to minimize inflammation, hemorrhage, pain and cellular metabolism during the acute post-injury phase and to optimize the potential for subsequent recovery.
Such initial treatment is often followed by protection of the injured tissues by immobilization for 1-3 weeks after the injury. Immobilization aims to allow healing to begin and to proceed undisturbed and it also prevents re-injury of the joint which often results in longer recovery times and can have long term effects. After tissue healing has begun, typically beyond 3 weeks post injury, controlled mobilization is introduced. At 4-8 weeks pest injury, more vigorous rehabilitation to recover muscle mass and joint function can begin.
Orthopedic repair of severe injuries is often performed as soon as acute swelling and hemorrhage of the injury subsides. However, physicians currently do not have a system or method available to differentiate between acute injury requiring invasive treatment and injuries that will heal sufficiently without such treatment.
It is particularly important to identify injuries that can result in joint deterioration before such deterioration begins. Currently, this kind of information can be obtained only by MRI imaging of the structural components of the joint to determine whether critical structural measures, such as cartilage volume, are being maintained or undergoing progressive degeneration. Typically, imaging is required at intervals of about 1-2 years after injury. Assay of marker proteins in joint fluid can also be used to detect and monitor joint deterioration. However, because such marker assays are generally based on a very limited number of gene products, and the abundance of the products in the fluid can be highly variable, their predictive capacity tends to be very limited.